Cognitive Behavioral Therapy (CBT) is a scientifically sound psychotherapeutic method which has shown to be effective in dealing with a wide variety of psychological disorders. This form of therapy aims to identify and change negative thought patterns, help manage harmful behavior, identify conscious and unconscious beliefs and attitudes, and, ultimately, help you to improve your state of mind.
CBT works with four interconnected concepts on the path to treatment management: thoughts, feelings, physicality and behavior. The basic principle of this therapy is that people can learn and change themselves and their behavior by working on each of these four levels.
For many psychological disorders, CBT is the first line of treatment. We cognitive behavioral therapists pay particular attention to the current problem area of the patient, without neglecting developments in childhood and adolescence. Together with the patient we investigate the potential causes of their problems; these may stem from their environment or may be due to (unfulfilled) expectations and attitudes. From this analysis, we deduce goals for therapy and support the patient in the development of their personal skills and strength and ultimately help to solve their problems.
Ultimately, CBT is always about bringing about lasting and concrete changes together with the patient.
As previously stated, in CBT we work with people on four different levels: thoughts, feelings, bodies and actions/activities. These areas all influence each other, as illustrated by the graphic below.
Let’s add some context: for example, have you ever been faced with a new, challenging task and thought to yourself, “I could never do that”, or, “that’s too difficult for me”? Feelings of discouragement or hopelessness arise as a consequence of these thoughts and these feelings also change the way you hold yourself and the tension in your muscles. With a feeling of hopelessness, you may find yourself slumping or feeling weak. This in turn reinforces the feeling of discouragement. A consciously controlled and upright posture can have a positive, therapeutic influence on your feelings or thoughts.
Below are a few example treatments for psychiatric disorders which take a CBD approach:
1. Actions /activities:
- Exposure Therapy: a method by which the patient experiences anxiety-provoking stimuli in order to treat fears or anxiety disorders such as agoraphobia or panic attacks. Facing the fear, either imagined (imaginal exposure) or in real life (in-vivo exposure), helps the patient to gradually overcome their fear of the particular situation which previously caused them anxiety.
- Role-playing allows you to try out new behaviors in a safe practice environment.
- Through behavioral experiments new attitudes, insights and actions can be tested directly in everyday life, so you can also learn and develop new social skills.
2. Thought level:
- The Socratic Dialogue. This approach is derived from the Greek philosopher, who asked many questions and questioned the answers he received philosophically. Therapy is always about self-knowledge. I help to recognize obstructive, inhibitory thoughts and replace them with more helpful thoughts.
- Identification of automatic and routinized thoughts. People have a multitude of automatic thoughts that rush through their heads in critical situations and determine behavior. These can be words, pictures or memories and can cause you to form potentially harmful habits. Working together to recognize these thoughts and the impact they have on you can help to change them and replace them with more helpful instincts.
- Recognizing core beliefs. Core beliefs are the personal, deep-seated attitudes and assumptions people hold about themselves, other people and their environment. We might not even be aware we hold them; they are situation-independent, rigid and not easily accessible yet they can significantly affect our lives. They are not always easy to recognize, but by doing so, we can eliminate negative thought patterns and behavior.
3. Physical-emotional levels:
- The analysis of emotions, change of emotions
- Mindfulness-based methods
- Helping people to find more time for themselves and especially to find moments to enjoy their daily lives and ultimately guide them to apply these techniques themselves in the long term.
- Stress management techniques
- Relaxation techniques (autogenic training, progressive muscle relaxation, breathing exercises).
CBT has undergone tremendous changes throughout its history, but one thing has remained the same: its scientific foundation. This means that the “old” techniques are just as valid as the new ones. CBT has become more complex, and cognitive behavioral therapists have the task of combining these different techniques within the therapy in the best possible way.
